PB2680: THE ACTOR-PARTNER INTERDEPENDENCE MEDIATION EFFECT OF INTIMATE RELATIONSHIP ON DYADIC COPING AND FEAR OF CANCER RECURRENCE IN PATIENTS AND THEIR SPOUSES WITH HEMATOLOGICAL MALIGNANCY AFTER HSCT
Authors: Qiuhui Zhang, Qing Zhang, LI Xu, Ling Zhang, Huijuan Zhang, Guiying Liu, Yuqiu Liu, Wei Guan, Erlie Jiang, Wenjun Xie
Journal: HemaSphere (2023)

Topic: 35. Quality of life and palliative care Background: Fear of cancer recurrence(FCR) refers to patients’ fear of recurrence, progression or metastasis of cancer at the primary site, which is one of the most common psychological burdens of patients and their spouses. Studies have shown that the incidence of FCR in patients who have survived more than one year after HSCT is as high as 95%. Excessive fear will reduce the quality of life of both husband and wife, thus affecting the whole family system. With the introduction of Bodenman’s systemic-transactional model theory, cancer coping has gradually developed from an individual perspective to a husband-and-wife dual perspective, that is, dyadic coping, which refers to the process in which intimate partners support each other and make decisions together in the face of chronic events such as life and disease. Some studies have shown that the level and quality of dyadic coping between husband and wife can predict their mental health. Other studies have shown that couples with a high level of intimacy can help ease each other’s stress and reduce the fear of cancer recurrence. Previous studies have mostly explored the relationship between the two variables from an individual perspective, but have not seen the interaction based on patients and spouses’ dyadic coping, intimate relationship and fear of cancer recurrence. In this study, the Actor-Partner Interdependence mediation model (APIMeM)was used to explore the mediating effect of the intimate relationship between patients and their spouses on dyadic coping and fear of cancer recurrence, so as to provide theoretical guidance for clinical staff to formulate scientific and effective dyadic intervention measures. Aims: To investigate the FCR in patients and their spouses with hematological malignancy after HSCT, and construct the APIMeM of intimate relationship on dyadic coping and FCR. Methods: A total of 249 hospitalized and reexamined Patients and their spouses after HSCT were investigated with general information questionnaire, Fear of Progression Questionnaire-Short Form(FoP-Q-SF), Dyadic Coping Inventory(DIC), the Lock-Wallace Marriage Relationship Adjustment Scale. Results: The score of patients FCR was lower than that of their spouses (P < 0.05), and the intimate relationship and dyadic coping were higher than those of their spouses (P < 0.05); The FCR of patients and their spouses was negatively correlated with their intimate relationship and positive dyadic coping, and positively correlated with their negative dyadic coping; In terms of Actor mediating effect: Patients’ positive dyadic coping and negative dyadic coping can affect their FCR through the intimate relationship on themselves’ and their spouses’; the spouse’s negative dyadic coping can only affect their FCR through their own intimate relationship; In terms of Partner mediating effect: Patients’ positive dyadic coping and negative dyadic coping can affect their spouse’s FCR through their spouse’s intimate relationship; Spouse’s negative dyadic coping can affect the patient’s FCR through the intimate relationship on themselves’ and their spouses’. Summary/Conclusion: The dyadic coping of patients after HSCT and their spouse can affect their own or their spouse’s FCR through the intimate relationship between the husband and wife, which suggest that medical staff should carry out dyadic intervention on the patient and spouse as a whole, improving the intimate relationship and reducing the FCR. Keywords: HSCT, Peripheral blood stem cell transplant, Patient